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Abstrak :
Respiration illness has some different symptoms basically is caused of irritation, failure of transparent muccociliari, more rekresi lender and respiration stricture. Children under tive years old at Primary Heath Care of Pangkalan Kerinci in Pelalawan District risk of respiration problem and based on result of annual report at Primary Health Care, respiration trouble illness is the tirst of ten illnesses at this area. lt is because of most public spend 90 % their time in room (house). Therefore research is pointed by the way of looking for relationship between PMN rate at house, house physical environment factor and children under tive years old characteristic which related to respiration problem occurrence becoming a reason. WHO estimated that there were 400-500 millions people who faced air pollution problem of variation room including headache, head cold, drought red lane, drought coughs, eye irritation, skin irritation, influenza, breathless and tuberculosis. This research purpose to know prevalence between respiration problem illness among children under tive years old, relationship of PMN rate at house, house physical environment factor (10 variables) and children under tive years old characteristic (5 variables) with respiration problem illness occurrence among children under tive years old, and looking for factor which is most dominance effect of respiration problem illness among children under tive years old at Primary Health Care of Pangkalan Kerinci, Pelalawan District in Riau Province, time period of Measurement appliance which is used to measure PM", rate at house consists of Haz Dust Sampler, EPAM S000 model, temperature by thennometer, dampness by hygrometer, illumination by luxmeter, and appliance which is used to get primary data of children under tive years old characteristic by questionnaire and checklist. 'l`his research used a cross sectional design which participating population of 615 Head of Family (KK) by sample number of 261 children under five years old, where data was collected at the same time of PMN, rate, house physic environment and children under five years old characteristic and there were not respiration problem illness occurrence among children under five years old. Based on research result which has been done it was indicated that: l). Prevalence of children under tive years old who faced of respiration problem illness was 78,2 % _ 2). Children under five years old house with PMN rate which did not fulfill requirement was 55,6 %, 3). There is no meaning ditference of PM", rate at house (p value = 0,393) with respiration problem among children under tive years old. 4). Habit of children under tive years old out of house has a meaning difference of respiration problem illness occurrence among children under tive years old by p- value = 0,007 and OR = 2,59 (95 % CI: 1,333-5,083). Children under ive years old who are out of house have risk of respiration problem illness 2,59 times compared with children under tive years old are out of house for long time. 5). Factor which is most dominance influencing respiration problem iilness occurrence among children under five years old are usage of fuel for cooking and children under tive years old who are out of house. Children under tive years old who are out of house have risk of respiration problem illness 2,59 times compared with children under five years old who are at house for long time, and also usage of fuel for cooking which became smoke has risk 2,32 times of reqriration problem illness compared with usage of Riel for cooking which did not become smoke (gas and electricity). 6). Probability of respiration problem illness occurrence among children under tive years old where they used fuel which will become smoke at their house and children under five years oId who have habit out of house 83,5 %. 7). Children under five years old who used fuel for cooking which became smoke (wood, charcoal and kerosene) and many activities of children under tive years old out of house have probabiiity of respiration problem illness occurrence 1,5 times bigger than children under five years old which used fuel for cooking which did not become smoke (gas and electrics) and many activities of children under five years old out of house.

Abstrak :
Pelayanan kesehatan primer merupakan elemen utama dari proses pelayanan kesehatan berkelanjutan. Pelayanan kesehatan primer didaulat sebagai level pertama kontak pasien terhadap pelayanan kesehatan. Namun dalam pelaksanaanya apabila tidak dilakukan dengan komprehensif akan berdampak terhadap kesenjangan pelayanan kesehatan di tingkat primer. Hal ini menunjukan bahwa pelaksanaan pelayanan kesehatan di tingkat primer belum optimal. Oleh sebab itu sistem gatekeeping dirancang untuk mengatasi masalah kesehatan utama di masyarakat yang dikemas secara terjangkau, melalui pelayanan kesehatan promotive, preventif, kuratif, dan rehabilitative. Penelitian ini bertujuan untuk mengetahui gambaran pelaksanaan dan dampak dari implementasi sistem gatekeeping di berbagai negara. Informasi pada penelitian ini diperoleh berdasarkan hasil penelusuran website dan jurnal yang telah dipublikasikan dengan bantuan akses online database seperti ScienceDirect, PubMed, Proquest, dan WileyOnline.Terdapat 10 studi yang termasuk kedalam penelitian ini. Hasil penelitian menunjukah bahwa sistem gatekeeping telah dilakukan di berbagai negara dengan kebijakan yang berbeda-beda. Faktor dukungan dari unsur tenaga kesehatan, fasilitas pelayanan kesehatan yang memadai dan status pendidikan pasien berkontribusi dalam efektivitas pelaksanaan sistem gatekeeping. Sistem gatekeeping berdampak positif yang menyebabkan utilisasi spesialis di fasilitas pelayanan kesehatan tingkat lanjut menurun dan menyebabkan biaya pengeluaran rendah. Namun, ditemukan bahwa pelaksanaan sistem gatekeeping berdampak negatif terhadap kepuasan pasien yaitu berkurangnya tingkat kepuasan pasien akibat waktu tunggu yang lebih lama dalam meengakses pelayanan kesehatan. ......Primary health care is the main element of the sustainable health care process. Primary health services are asked to be the first level of patient contact with health services. However, if it is not carried out comprehensively, it will have an impact on health services at the primary level. This shows that the implementation of health services at the primary level has not been optimal. Therefore, the gatekeeping system is designed to address the main health problems in the community that are packaged in an affordable way, through promotive, preventive, curative and rehabilitative health services. This study aims to describe the implementation and impact of the implementation of the gatekeeping system in various countries. The information in this study was obtained based on the results of browsing websites and journals that have received assistance in accessing online databases such as ScienceDirect, PubMed, Proquest, and WileyOnline. There are 10 studies included in this study. The results of the study show that the gatekeeping system has been carried out in various countries with different policies. Support factors from elements of health workers, adequate health care facilities and patient education status contribute to the effectiveness of the implementation of the gatekeeping system. The gatekeeping system has a positive impact on reducing visits to specialists and plays a role in reducing utilization and costs. However, in patient satisfaction the implementation of the gatekeeping system was found to have a negative impact, namely reducing the level of patient satisfaction due to long waiting times in accessing health services.

Abstrak :
Penelitian ini bertujuan untuk melihat gambaran keluhan dan faktor risiko fatigue pada perawat Puskesmas Kecamatan Kota Administrasi Jakarta Barat di masa pandemi COVID-19. Penelitian ini menggunakan desain studi cross-sectional dengan metode kuantitatif dan kualitatif. Penelitian ini dilakukan kepada 117 perawat di 5 Puskesmas Kecamatan Kota Administasi Jakarta Barat pada November – Desember 2020. Variabel dependen dari penelitian ini adalah keluhan fatigue. Sementara itu, variabel independen dari peneiltian ini adalah faktor risiko terkait individu (usia, jenis kelamin, masa kerja, keluhan sakit, status gizi, kuantitas tidur) dan faktor risiko terkait pekerjaan (shift kerja, durasi kerja, jam istirahat, stigma sosial). Pengambilan data primer dilakukan dengan pengisian kuesioner untuk penilaian fatigue dan faktor risiko serta wawancara untuk penelusuran dan konfirmasi data. Hasil menunjukkan bahwa 35,7% responden mengalami fatigue sedang-berat. Keluhan fatigue sedang-berat cenderung dialami oleh perawat yang berusia > 46 tahun (50,0%), wanita (36,8%), masa kerja < 5 tahun (40,8%), belum memiliki anak (47,4%), memiliki keluhan sakit (63,9%), gizi kurang (100%), kuantitas tidur kurang (50,9%), bekerja dalam shift (40,5%), durasi kerja berlebih (51,7%), jam istirahat kurang (66,7%), dan tidak pernah mengalami stigma sosial (33,7%).

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This study described the fatigue problem dan its risk factors among sub-district level primary health care center nurses in West Jakarta during COVID-19 pandemic. This study was a descriptive cross-sectional study with quantitative and qualitative method. The subjects were nurses from 5 sub-district level primary health care center participated in November – December 2020. The dependent variable was fatigue problem. Whereas, the independent variables were individual factors (age, gender, length of service, health complaints, nutrition status, sleep duration) and work-related factors (shift work, work duration, rest break, social stigma). This study used fatigue and risk factors questionnaire and interview to confirm the data. Results showed that 35,7% subjects experienced medium-severe fatigue. Medium-severe fatigue were found higher in subjects who were > 46 years (50,0%), women (36,8%), had < 5 years length of service (40,8%), had health complaints (63,9%), underweight (100%), had sleep deprivation (50,9%), worked in shift (40,5%), had long work duration (51,7%), had short rest break (66,7%), and never experienced social stigma (33,7%).